Clinical impact and evolution of mitral regurgitation after TAVI using the new generation self-expandable valves

Giannini, Cristina; Angelillis, Marco; Fiorina, Claudia; Tamburino, Corrado; Bedogni, Francesco; Bruschi, Giuseppe; Montorfano, Matteo; Poli, Arnaldo; Felice, Francesco De; Reimers, Bernhard; Branca, Luca; Barbanti, Marco; Testa, Luca; Merlanti, Bruno; Petronio, Anna Sonia

doi:10.1016/j.ijcard.2021.03.071

Cited by 3 publications

(2 citation statements)

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“…There is no doubt that TAVR is a valuable treatment option reflected in current ESC guidelines on valvular heart disease [9]. There are numerous data on the beneficial role of TAVR and many papers have shown a significant MR reduction immediately after or during follow-up after TAVR [26][27][28][29][30][31]. Similar results were reported for patients with low-flow and low gra-dient AS [32].…”

Section: Discussionmentioning

confidence: 73%

Balloon aortic valvuloplasty for severe aortic stenosis may reduce mitral regurgitation in mid-term follow-up

Kleczyński¹,

Brzychczy²,

Kulbat³

et al. 2022

pwki

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Introduction: Mitral regurgitation (MR) is a frequent complication in patients with severe aortic stenosis (AS). Material and methods: Echocardiographic assessment of MR was performed at baseline, at 30 days and at 6 months after balloon aortic valvuloplasty (BAV).Results: Data of 271 patients were included in our final analysis, of which 21.2% (n = 85) had at least moderate MR at baseline (in 19 (22.3%) subjects MR was diagnosed as primary). Both groups showed similar severity of AS, but patients in the MR group had a greater left ventricle (LV) size (p = 0.003 for LVESD, p = 0002 for LVEDD) and slightly lower LV ejection fraction (p = 0.04). Mitral regurgitation parameters significantly improved both at 30 days and 6 months after BAV in the MR group (MR jet area: 7.2 (4.5-9.9) vs. 3.6 (2.3-7.2) cm 2 , and 7.2 (4.5-9.9) vs. 3.2 (2.1-6.7) cm 2 ; %MR/left atrial area 34.5 (23.4-42.7) vs. 17.5 (9.3-29.5) and 34.5 (23.4-42.7) vs. 14.5 (8.3-24.5), p < 0.001 for all). In multivariate logistic regression analysis, the change at 30 days, from baseline, in the LVESD (OR = 1.87; 95% CI: 1.23-2.87; p < 0.001) and LVEF (OR = 0.95; 95% CI: 0.87-1.01; p < 0.001); MR jet area (OR = 2.2, 95% CI: 1.5-4.6; p < 0.001) and the presence of primary MR (OR = 3.2, 95% CI: 1.04-5.98; p < 0.001) were retained as independent predictors of significant persisting MR at 6 months.Conclusions: Balloon aortic valvuloplasty may reduce MR in mid-term follow-up. Predictors of persistent MR at 6 months after BAV included an increase of LVESD and MR jet area and decrease of LVEF at 30 days.

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Section: Discussionmentioning

confidence: 73%

Balloon aortic valvuloplasty for severe aortic stenosis may reduce mitral regurgitation in mid-term follow-up

Kleczyński¹,

Brzychczy²,

Kulbat³

et al. 2022

pwki

View full text Add to dashboard Cite

show abstract

“…In a propensity score-matched cohort with significant residual MR after TAVR, staged mitral intervention (repair or replacement) was associated with a better functional class [ 33 ]. A similar analysis (observational, n: 2964) showed a higher prevalence of baseline MR grade ≥ moderate (41.6%) which was also associated with increased mortality; however, the use of newer generation self expandable valves was associated with higher survival rate at 1 year irrespective of the degree of pre-procedural MR. [ 34 ]…”

Section: Introductionmentioning

confidence: 99%